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Correspondence
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Volume 346:630-631 February 21, 2002 Number 8
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Emergence of Macrolide Resistance during Treatment of Pneumococcal Pneumonia

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To the Editor: The emergence of antibiotic resistance during treatment for pneumococcal infection is exceedingly rare.1 To our knowledge, there is no previous report of a genetically characterized, antibiotic-resistant pneumococcal mutant emerging during therapy and serving as the cause of treatment failure.

A previously healthy 28-year-old man presented with a five-day history of cough and dyspnea. He had hypotension, hypothermia, and rales in the right upper lung. His white-cell count was 14,000 per cubic millimeter (28 percent bands). Chest roentgenography showed infiltrates in the right middle and upper lobe. The sputum contained abundant gram-positive diplococci, and culture yielded Streptococcus pneumoniae; . . . [Full Text of this Article]

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